Citation Nr: 21003579 Decision Date: 01/22/21 Archive Date: 01/22/21 DOCKET NO. 16-23 246 DATE: January 22, 2021 REMANDED Entitlement to service connection for a right hip condition, claimed as right hip strain, to include as secondary to her service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty in the Army from September 2007 to July 2011. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a February 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) (hereinafter Agency of Original Jurisdiction (AOJ)) in Waco, Texas. In May 2018, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearings is of record. In September 2018, the Board remanded the appeal for further development. Specifically, the Board directed the RO to attempt to obtain additional medical records and to obtain medical opinions of the etiology of the Veteran’s claimed left ankle and thyroid disabilities. These directives have been completed. In April 2020, the Board remanded the appeal for further development. Specifically, the Board directed the RO to attempt to obtain additional medical records and to obtain medical opinions of the etiology of the Veteran’s claimed right hip disability. These directives have been completed. In a January 2020 rating decision, the AOJ granted the Veteran’s claims for service connection for a left ankle disability and a thyroid disability. These awards constitute a full grant of the disability sought, and those appeals have been resolved. See Grantham v. Brown,114 F.3d 1156 (Fed. Cir. 1997) (holding that where an appealed claim for service connection is granted during the pendency of the appeal, a second notice of disagreement must thereafter be timely filed to initiate appellate review of the claim concerning “downstream” issues, such as the compensation level assigned for the disability and the effective date). 1. Entitlement to service connection for a right hip condition, claimed as right hip strain, to include as secondary to her service-connected disabilities, is remanded. In a September 2020 correspondence, the Veteran asserts that she had psoriasis in service and that she currently has psoriatic arthritis which impacts her right hip. The Board cannot make a fully-informed decision on the issue of service connection for a right hip condition because no VA examiner has opined whether the Veteran’s right hip complaints are related to her in-service psoriasis. The Veteran’s service treatment records show that in May 2011, she was treated for dry skin on her feet which was diagnosed as xerosis cutis. In July 2011, she was diagnosed with psoriasis. In a March 2016 VA examination, the examiner noted that the Veteran had xerosis cutis with a diagnosis date of October 2010. The examiner did not discuss the July 2011 diagnosis of psoriasis. Rather, the examiner mistakenly opined that The Veteran does not have a diagnosis of psoriasis currently or in the service. Therefore, the claimed diagnosis of psoriasis is not least as likely as not (less than 50 percent probability) incurred in or caused by (the) diagnosis noted in records during service. However, the Veteran was diagnosed with xerosis cutis of the heels while in military and still persists on exam today. Therefore, the xerosis cutis is at least as likely as not (50 percent or greater probability) incurred in or caused by (the) diagnosis noted in records during service. In an April 2016 rating decision, the RO awarded service connection for xerosis cutis, claimed as psoriasis. In December 2018, the Veteran was diagnosed with psoriatic arthritis. She was noted to have skin symptoms including patches of psoriasis on her legs. In February 2019, the Veteran’s treating physician noted dermal psoriasis and psoriatic arthritis. In May 2019, the Veteran was noted to have patches of psoriasis on her legs. A VA opinion in April 2020 indicated that the Veteran had xerosis cutis and did not answer the question posed by the Board in light of the finding that she may have psoriatic arthritis rather than xerosis cutis. The medical evidence clearly indicates that the Veteran’s skin condition has been diagnosed as psoriasis and she has subsequently been diagnosed with psoriatic arthritis, which could therefore be related to her right hip service connection claim. Therefore, this issue is being remanded to obtain a medical opinion on whether the Veteran has psoriasis and whether the Veteran’s right hip symptoms are attributable to this condition, to include psoriatic arthritis. The matters are REMANDED for the following action: 1. Obtain the Veteran’s complete service treatment records, to include entry and separation physical examinations, and associate them with the claims file. 2. Identify and obtain any outstanding VA and private treatment records that are not already associated with the claims file. If any record identified cannot be obtained, the Veteran and her representative should be notified of this in writing, to include all efforts taken by VA to attempt to obtain any such record. The Veteran should also be offered the option to provide any such record herself. 3. The RO should reevaluate the grant of service connection for xerosis cutis in light of the evidence of an in-service July 2011 diagnosis of psoriasis. 4. Thereafter, the RO should obtain an opinion from a VA rheumatologist to address the medical questions of whether the Veteran post-service diagnosis of psoriatic arthritis at least as likely as not had its onset in service or is related to the Veteran’s service. In so doing, the examiner should review the 2011 evaluations for skin symptoms. If, and only if, the examiner finds that the Veteran’s psoriatic arthritis is related to service, the AOJ should also seek a medical opinion that addresses whether the Veteran’s right hip condition is least as likely as not related to/developed secondary to her psoriatic arthritis. The complete rationale for all opinions should be set forth. A discussion of the facts and the medical principles involved will be of considerable assistance to the Board. The examiner is advised that the Veteran is competent to report her symptoms and history. Such reports, including those of continuity of symptomatology, must be acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran’s reports, the examiner must provide an explanation for such rejection. 5. After undertaking any other development deemed appropriate, the AOJ should readjudicate the issues on appeal. If any benefits sought are not granted, the AOJ should issue a supplemental statement of the case and provide the Veteran, and her representative, with an appropriate opportunity to respond. The case should then be returned to the Board for further appellate consideration. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Michael J. O’Connor The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.